Oral Cancer News

Study Identifies Potential Cause of Hearing Loss from Cisplatin

Author: NCI Staff
Date: January 26, 2018
Source: National Cancer Institute (https://www.cancer.gov/news-events)

Results from a new study may explain why many patients treated with the chemotherapy drug cisplatin develop lasting hearing loss.

Researchers found that, in both mice and humans, cisplatin can be found in the cochlea—the part of the inner ear that enables hearing—months and even years after treatment. By contrast, the drug is eliminated from most organs in the body within days to weeks after being administered.

The study, led by researchers from the National Institute on Deafness and other Communication Disorders (NIDCD), part of the National Institutes of Health, was published November 21 in Nature Communications.

Cisplatin, a platinum-based chemotherapy drug, is commonly used for the treatment of many cancers, including bladder, ovarian, and testicular cancers. But cisplatin and other similar platinum-containing drugs can damage the cochlea, leaving 40%–80% of adults, and at least 50% of children, with significant permanent hearing loss, a condition that can greatly affect quality of life.

“This study starts to explain why patients who receive the drug sustain hearing loss,” said Percy Ivy, M.D., associate chief of NCI’s Investigational Drug Branch, who was not involved in the study. “This is very important, because as we come to understand how cisplatin-related hearing loss occurs, over time we may figure out a way to block it, or at least diminish its effects.”

A New Approach to Researching Cisplatin-Induced Hearing Loss

The new study differs from previous research because it is a comprehensive look at the pharmacokinetics, or concentration, of the drug in the inner ear, explained study investigator Andrew Breglio, of NIDCD.

The research team primarily used a technique called inductively coupled plasma mass spectrometry (ICP-MS) to quantify the amount of platinum left in inner ear tissue following cisplatin treatment in mice.

Lisa Cunningham, Ph.D., of NIDCD, who led the research team, noted that instead of using one high dose of cisplatin with mice as other studies have, they developed a treatment protocol like those used in everyday care, in which the drug is given in cycles.

Testing done following each cisplatin cycle showed increasingly progressive hearing loss in the mice. The researchers also measured platinum levels in various organs throughout the drug cycles and found that, whereas other organs eliminated the drug relatively quickly, the cochlea retained the cisplatin, showing no significant loss of platinum 60 days after the last administration of the drug.

The researchers also conducted postmortem analysis of inner ear tissue of human patients who had received cisplatin, and found that platinum was retained in cochleae at least 18 months after the last treatment. In addition, they found that in the cochlea of one pediatric patient (the only one available for study), significantly more platinum was retained than in adult patients, consistent with the fact that children’s ears are known to be more susceptible to cisplatin-induced hearing loss.

In both the mouse model and in studies of human tissue, the researchers determined that the platinum accumulates in a part of the cochlea called the stria vascularis, which, Breglio explained, regulates the makeup of the fluid that bathes the sensory hair cells in the ear “and is critical to their proper function.”

This lengthy retention in the cochlea could explain why this drug is damaging the inner ear, Breglio said. Furthermore, these findings, demonstrating the accumulation of the drug and identifying where it is retained, mean that future studies need to “look beyond hair cells” to explain cisplatin-induced hearing loss, the researchers wrote.

Findings That Could Lead to Hearing Loss Treatment and Prevention

The finding that cisplatin is retained in the cochlea indefinitely is important for patient care, Dr. Ivy said.

Hearing loss from cisplatin “is not a static injury, it doesn’t stay the same. It can progress over time and it can occur late,” she added. “That suggests that a long-term survivor needs ongoing monitoring of their hearing.”

She said it will be up to practitioners to continue this monitoring and to rapidly intervene with devices that assist in hearing, such as hearing aids.

Hearing loss can have a particularly negative impact on children, she said.

“If adults develop hearing loss, they’re more acutely aware of it, and are more likely to seek assistance, whereas younger children who develop hearing loss might not notice it as much or be unable to explain the problem,” she explained. “Since they can’t hear very well, they may have trouble paying attention and that could be misconceived as a learning disability or a behavior problem. And yet, if they get the appropriate intervention, they perform at the same level they did prior to receiving platinum.”

This is why researchers on Dr. Cunningham’s team are trying to find ways to block cisplatin from entering the inner ear. They are looking at the cellular mechanism by which cisplatin is taken up by the cells of the stria vascularis to find ways to block uptake, as well as identify drugs that might “target cisplatin itself, and bind it or sequester it” before it can get into the inner ear, Breglio said.

“[Cisplatin] is one of the most widely used anticancer drugs on the planet, and it’s saving a lot of lives,” Dr. Cunningham said. But the hearing loss is permanent. “So these patients are surviving and they have this hearing loss for the rest of their lives. What we’d like to be able to do is develop a therapy that will allow patients to take the life-saving drug, but preserve their hearing.”

 

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January, 2018|Oral Cancer News|

NHS immunises girls but not boys against potentially deadly HPV virus because its ‘not cost-effective’

Source: www.thesun.co.uk
Author: Jacob Dirnhuber

Girls aged 12 to 13 are already vaccinated for free against the HPV virus, which can cause deadly tumours in the throat and mouth, but boys have to do without.

Experts believe it would take £22 million a year to vaccinate every boy in Britain against the deadly disease – a fraction of the vast £148 billion NHS budget. But low overall infection rates mean that bean-counters refuse to sign off on any additional funding – condemning thousands to months of expensive, agonising cancer treatment.

Cambridge University Professor Margaret Stanley blasted: “You cannot protect against these cancers by only vaccinating half the population.”

She told the Mail on Sunday: “Not to immunise boys is classic Treasury short-termism. You may not spend so much now, but it will cost far more years later.

“We are in the midst of an HPV pandemic.”

HPV is generally spread through genital and oral sex, and can also be transmitted by kissing – meaning that some people who contract it are virgins. Only a tiny minority of those infected go on to develop cancer, often decades after they contract the virus. An estimated 80 per cent of all adults in the UK have been infected at some point.

Throat and cancer specialist Professor Christopher Nutting said: “My patients are being struck down by a preventable cancer that will affect them for the rest of their lives.

“It’s unfair that women are protected but men are not. The vaccine will work. It is starting to make cervical cancer incredibly rare. Why wouldn’t we do the same for cancer of the throat?’

Figures show that in 2011 alone the HPV virus triggered cancers in 1,850 people – and a staggering 1,400 of those were men.

Businessman Chris Curtis, 59, who contracted oropharyngeal cancer after becoming infected, said: “There is something out there that can stop this happening. We’ve got to use it.”

Opening up about his harrowing time with the disease, he said: “My family would eat in the dining room and I would be stuck being fed through my tube by machine.

“I planned suicide twice. All that stopped me was the thought of my kids.

“You’ve seen the cream-cracker challenge? ” live with that every minute of every day. I look at a burger and chips and I see cardboard. If I eat a tomato, it feels like it’s exploding in my mouth – it’s intolerable.

“For months the cancer takes over your life, and there is no respite. It tests you to breaking point.”

Prof Pollard, of the NHS Joint Committee on Vaccination and Immunisation, said the committee could only recommend vaccinating boys if it found this conformed with the “health technology assessment methodology’, which is derived from the Treasury’s ‘Green book’.

“Under the rules we are only looking at cost-effectiveness from the health providers’ perspective.”

“Each possible vaccine had to be considered in the context of the NHS as a whole”

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January, 2018|Oral Cancer News|

New “soft” laser treatment to improve quality of life for cancer patients

Source: www.world-first.co.uk
Author: staff

A new “soft” laser therapy is to be used nationwide to help prevent patients undergoing treatment for neck and head cancer from suffering severe side effects.

The low-level laser therapy (LLLT), or photomedicine, will help prevent patients suffering from soreness in the mouth and throat, dry mouth and swallowing problems.

More than 90% of the 4,000 people a year in England and Wales who receive chemoradiotherapy for head and neck cancer experience side effects which can lead to hospital admissions and, in some cases, interrupt the course of radiotherapy.

The new treatment, developed by the NHS foundation trusts of University Hospital Southampton and Newcastle Upon Tyne Hospitals, is being trialled nationwide as part of a £1.2 million study funded by the National Institute for Health Research (NIHR).

One of the main complications of current treatments is oral mucositis (OM), which affects taste and speech. It causes excessive secretions of saliva, which result in nausea, vomiting and weight loss. Currently, patients are treated with a combination of painkillers and anti-sickness drugs and many require frequent hospital appointments to control their symptoms. Some also need nutritional support through nasal or stomach feeding tubes.

LLLT is a drug-free treatment that stimulates damaged cells using a low energy laser beam to reduce pain and inflammation. It’s more commonly used to treat musculoskeletal problems such as tendon, bone and nerve damage.

Consultant clinical oncologist at Southampton General Hospital Dr Shanmugasundaram Ramkumar said the LLLT would improve quality of life for patients.

“If shown to be effective in this large multi-centre study, it could radically change the management of this group of patients in the UK and worldwide,” he said.

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January, 2018|Oral Cancer News|

Dr. Califano discusses the role of surgery in head and neck cancer

Source: www.onclive.com
Author: Joseph A. Califano, MD

Joseph A. Califano, MD, professor of surgery, University of California, San Diego, discusses the role of surgery in head and neck cancer.

The surgeon has evolved to have a more integrative role in patient care for those with head and neck cancer. Current surgical techniques used in the treatment of head and neck cancers have greatly evolved in the last two decades. Surgery is more precise, and leaves patients with excellent function and cosmetic results by incision through natural orifices, Califano says.

Robotic surgery is the cornerstone of head and neck cancer surgery, says Califano. It is effective in terms of resecting tumors of the throat, tonsils, back of the tongue, and the nasopharynx—which are hard to reach without robotic instrumentation. Califano says that the benefits of robotic surgery in this setting are that it leaves patients with excellent function, swallowing, voice, and allows for a rapid recovery.

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January, 2018|Oral Cancer News|

Anti-smoking plan may kill cigarettes–and save Big Tobacco

Date: January 19, 2018
Author: Matthew Perrone
Source: www.apnews.com

WASHINGTON (AP) — Imagine if cigarettes were no longer addictive and smoking itself became almost obsolete; only a tiny segment of Americans still lit up. That’s the goal of an unprecedented anti-smoking plan being carefully fashioned by U.S. health officials.

But the proposal from the Food and Drug Administration could have another unexpected effect: opening the door for companies to sell a new generation of alternative tobacco products, allowing the industry to survive — even thrive — for generations to come.

The plan puts the FDA at the center of a long-standing debate over so-called “reduced-risk” products, such as e-cigarettes, and whether they should have a role in anti-smoking efforts, which have long focused exclusively on getting smokers to quit.

“This is the single most controversial — and frankly, divisive — issue I’ve seen in my 40 years studying tobacco control policy,” said Kenneth Warner, professor emeritus at University of Michigan’s school of public health.

The FDA plan is two-fold: drastically cut nicotine levels in cigarettes so that they are essentially non-addictive. For those who can’t or won’t quit, allow lower-risk products that deliver nicotine without the deadly effects of traditional cigarettes.

 

US health officials are pushing ahead with an unprecedented plan to make cigarettes less addictive and provide lower-risk alternative products to US smokers. (Jan. 19)

This month the government effort is poised to take off. The FDA is expected to soon begin what will likely be a years-long process to control nicotine in cigarettes. And next week, the agency will hold a public meeting on a closely watched cigarette alternative from Philip Morris International, which, if granted FDA clearance, could launch as early as February.

The product, called iQOS (pronounced EYE-kose), is a penlike device that heats Marlboro-branded tobacco but stops short of burning it, an approach that Philip Morris says reduces exposure to tar and other toxic byproducts of burning cigarettes. This is different from e-cigarettes, which don’t use tobacco at all but instead vaporize liquid usually containing nicotine.

For anti-smoking activists these new products may mean surrendering hopes of a knockout blow to the industry. They say there is no safe tobacco product and the focus should be on getting people to quit. But others are more open to the idea of alternatives to get people away from cigarettes, the deadliest form of tobacco.

Tobacco companies have made claims about “safer” cigarettes since the 1950s, all later proven false. In some cases the introduction of these products, such as filtered and “low tar” cigarettes, propped up cigarette sales and kept millions of Americans smoking. Although the adult smoking rate has fallen to an all-time low of 15 percent, smoking remains the nation’s leading preventable cause of death and illness, responsible for about one in five U.S. deaths.

Anti-smoking groups also point to Big Tobacco’s history of manipulating public opinion and government efforts against smoking: In 2006, a federal judge ruled that Big Tobacco had lied and deceived the American public about the effects of smoking for more than 50 years. The industry defeated a 2010 proposal by the FDA to add graphic warning labels to cigarette packs. And FDA scrutiny of menthol-flavored cigarettes — used disproportionately by young people and minorities — has been bogged down since 2011, due to legal challenges.

“We’re not talking about an industry that is legitimately interested in saving lives here,” said Erika Sward of the American Lung Association.

But some industry observers say this time will be different.

“The environment has changed, the technology has changed, the companies have changed — that is the reality,” said Scott Ballin, a health policy consultant who previously worked for the American Heart Association.

Under a 2009 law, the FDA gained authority to regulate certain parts of the tobacco industry, including nicotine in cigarettes, though it cannot remove the ingredient completely. The same law allows the agency to scientifically review and permit sales of new tobacco products, including e-cigarettes. Little has happened so far. Last year, the agency said it would delay the deadline for manufacturers to submit their vapor-emitting products for review until 2022.

The FDA says it wants to continue to help people quit by supporting a variety of approaches, including new quit-smoking aids and opening opportunities for a variety of companies, including drugmakers, to help attack the problem. As part of this, the FDA sees an important role for alternative products — but in a world where cigarettes contain such a small amount of nicotine that they become unappealing even to lifelong smokers.

“We still have to provide an opportunity for adults who want to get access to satisfying levels of nicotine,” but without the hazards of burning tobacco, said FDA Commissioner Dr. Scott Gottlieb. He estimates the FDA plan could eventually prevent 8 million smoking-related deaths.

“SMOKE-FREE FUTURE”

Philip Morris International and its U.S. partner Altria will try to navigate the first steps of the new regulatory path next week.

At a two-day meeting before the FDA, company scientists will try and convince government experts that iQOS is less-harmful than cigarettes. If successful, iQOS could be advertised by Altria to U.S. consumers as a “reduced-risk” tobacco product, the first ever sanctioned by the FDA.

Because iQOS works with real tobacco the company believes it will be more effective than e-cigarettes in getting smokers to switch.

Philip Morris already sells the product in about 30 countries, including Canada, Japan and the United Kingdom.

iQOS is part of an elaborate corporate makeover for Philip Morris, which last year rebranded its website with the slogan: “Designing a smoke-free future.” The cigarette giant says it has invested over $3 billion in iQOS and eventually plans to stop selling cigarettes worldwide — though it resists setting a deadline.

Philip Morris executives say they are offering millions of smokers a better, less-harmful product.

Matthew Myers of the Campaign for Tobacco-Free Kids still sees danger. He says FDA must strictly limit marketing of products like iQOS to adult smokers who are unable or unwilling to quit. Otherwise they may be used in combination with cigarettes or even picked up by nonsmokers or young people who might see the new devices as harmless enough to try.

“As a growing percentage of the world makes the decision that smoking is too dangerous and too risky, iQOS provides an alternative to quitting that keeps them in the market,” Myers says.

It’s unclear whether existing alternatives to cigarettes help smokers quit, a claim often made by e-cigarette supporters. Research from the Centers for Disease Control and Prevention suggests about 60 percent of adult e-cigarette users also smoke regular cigarettes.

THE CASE FOR LOWER NICOTINE

Experts who study nicotine addiction say the FDA plan is grounded in the latest science.

Several recent studies have shown that when smokers switch to very low-nicotine cigarettes they smoke less and are more likely to try quitting. But they also seek nicotine from other sources, underscoring the need for alternatives. Without new options, smokers would likely seek regular-strength cigarettes on the black market.

Crucial to the FDA proposal is a simple fact: nicotine is highly addictive, but not deadly. It’s the burning tobacco and other substances inhaled through smoking that cause cancer, heart disease and bronchitis.

“It’s hard to imagine that using nicotine and tobacco in a way that isn’t burned, in a non-combustible form, isn’t going to be much safer,” said Eric Donny, an addiction researcher at the University of Pittsburgh.

A study of 800 smokers by Donny and other researchers showed that when nicotine was limited to less than 1 milligram per gram of tobacco, users smoked fewer cigarettes. The study, funded by the FDA, was pivotal to showing that smokers won’t compensate by smoking more if nicotine intake is reduced enough. That was the case with “light” and “low-tar” cigarettes introduced in the 1960s and 1970s, when some smokers actually began smoking more cigarettes per day.

Still, many in the anti-smoking community say larger, longer studies are needed to predict how low-nicotine cigarettes would work in the real world.

LEGAL RISKS

Key to the FDA plan is the assumption that the two actions will happen at the same time: as regulators cut nicotine in conventional cigarettes, manufacturers will provide alternative products.

But that presumes that tobacco companies will willingly part with their flagship product, which remains enormously profitable.

Kenneth Warner, the public policy professor, said he would be “astonished” if industry cooperates on reducing nicotine levels.

“I don’t think they will. I think they will bring out all of their political guns against it and I’m quite certain they will sue to prevent it,” he said.

In that scenario, the FDA plan to make cigarettes less addictive could be stalled in court for years while companies begin launching FDA-sanctioned alternative products. Tobacco critics say that scenario would be the most profitable for industry.

“It’s like Coke, you can have regular Coke, Diet Coke, Coke Zero, we’ll sell you any Coke you like,” said Robin Koval, president of the Truth Initiative, which runs educational anti-tobacco campaigns.

But the FDA’s Gottlieb says the two parts of the plan must go together. “I’m not going to advance this in a piecemeal fashion,” he said.

When pressed about whether industry will sue FDA over mandatory nicotine reductions, tobacco executives for Altria and other companies instead emphasized the long, complicated nature of the regulatory process.

“I’m not going to speculate about what may happen at the end of a multiyear process,” said Jose Murillo, an Altria vice president. “It will be science and evidence-based and we will be engaged at every step of the way.”

 

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January, 2018|Oral Cancer News|

Study provides new guidelines for assessing severity of head and neck cancers

Source: eurekalert.org
Author: press release Cedars-Sinai Medical Center

Cedars-Sinai investigators have developed a new, more accurate set of guidelines for assessing the severity of head and neck cancers and predicting patient survival.

The new guidelines, outlined in a study recently published in the Journal of Clinical Oncology, center around counting the number of malignant lymph nodes found in each patient.

“The greater the number of malignant lymph nodes, the less favorable the patients’ chances of survival,” said Allen S. Ho, MD. Ho is director of the Head and Neck Program at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai and lead author of the study. “This new approach could dramatically simplify staging systems.”

For decades, doctors have determined the stage and predicted the progression of head and neck cancers based primarily on nodal size, location and how far the cancer has spread beyond the lymph nodes, but they have given less importance to the number of cancerous nodes. As a result, staging and treatment recommendations, based on current national guidelines, “are the same whether a patient has two or 20 positive lymph nodes,” said Zachary S. Zumsteg, MD, assistant professor of Radiation Oncology at Cedars-Sinai and the study’s senior author.

With the new system, based on the number of cancerous lymph nodes, patients are separated into similarly sized groups with distinct outcomes, Zumsteg said. “Our study demonstrated a better way to assess cancer severity, which will improve our ability to predict outcomes and give patients more personalized treatment.”

The Cedars-Sinai study involved reviewing data of 14,554 U.S. patients identified in the National Cancer Database who were treated for squamous cell carcinoma of the oral cavity (mouth, gum and tongue) between 2004 and 2013.

The data showed that an increased risk of death was associated with each additional cancerous lymph node found. The investigators concluded that the number of cancerous lymph nodes is a predominant, independent factor associated with death in those patients. The study also identified an ultra-high-risk group of patients with five or more cancerous lymph nodes.

Head and neck cancers occur in the lips, tongue, gums, bottom of the mouth, throat, larynx, nasal cavity and salivary glands. About 63,000 people developed head and neck cancers in the U.S. in 2017. More than 13,000 deaths from those cancers occurred during that period, according to the American Society of Clinical Oncology.

“Although considering the number of cancerous lymph nodes in staging is a simple concept that many head and neck cancer specialists have assumed to be true for years, data has been limited until now,” Zumsteg said. The study authors said they hope that, based on the new data, the number of positive nodes in staging will now be incorporated into clinical practice.

Notes:
1. Research reported in this publication was supported in part by the National Institutes of Health under award number R01 CA188480-01A1, National Center for Advancing Translational Sciences under award numbers UL1TR000124 and UL1TR001881-01, the Donna and Jesse Garber Award for Cancer Research and the Health Network Foundation Service Excellence Award.

Disclosure: Dr. Zumsteg serves on the external advisory board of the Scripps Proton Therapy Center and has been a paid consultant for EMD Serono.

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January, 2018|Oral Cancer News|

Cancer survivors are transforming their radiation masks into art

Source: www.artsy.net
Author: Ryan Leahey

Photos by Ulf Wallin Photography

In a Baltimore basement, behind foot-thick walls, there is a room, and in that room there is a table. Every morning, Monday through Friday for seven weeks, my dad entered the room at 7:40 a.m. sharp. I accompanied him there on a few occasions, sitting outside in the waiting room as the door closed behind him. A minute or two would pass, followed by a barely audible buzz, then the door would slide open again and he’d walk out, another radiation treatment X’d off the calendar.

My dad’s experience in that room, one of many in the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, will be familiar to other throat cancer patients. A radiation technician bolted him down to the table with the help of a white mesh mask perfectly molded to the contours of his face. Wrapped tightly around his head and neck, the bizarre-looking armature ensured that powerful radiation beams targeted his cancer in the exact same position each session, even as his skin deteriorated and his body mass dropped.

Before his first treatment, he had been measured and fitted for his own custom mask. Plastic mesh was draped over his face until it hardened, forming a new face—what some patients call their second skin. For my dad, the object came to symbolize something, just as it symbolizes something for me, our family, and for the countless other people who have survived or helped someone survive head and neck cancer, or HNC.

My dad isn’t exactly the sentimental type, but on his last day of radiation, he rang the bell—a rite of passage for patients who make it through treatment—put the mask in his car trunk, and took it home.

 

Photo by Ulf Wallin Photography

The mask worn by Ryan Leahey’s father during radiation treatment. Courtesy of the author.

Just as cancers and treatments are unique, however, the meaning of the mask is unique to every patient and to every person who comes into contact with it. Among those searching for that meaning are hundreds of artists, some of them survivors themselves, who have transformed radiation masks into works of art that seek to capture, or at least confront, the struggle and, for the lucky ones, the survival of HNC.

Groups across the U.S. and other parts of the world have come together to create new lives for these masks. One such group, Courage Unmasked, has, through a series of auctions and books, shown off an incredible array of masks, all while raising awareness of HNC and funds for patients in need.

Courage Unmasked is the brainchild of Cookie Kerxton, an artist and HNC survivor. In 2009, Kerxton felt lucky. She was fortunate to have had the finances and good health to survive her radiation treatment for cancer of the vocal cords. As Kerxton convalesced, she realized that not everyone is quite so lucky. Some HNC patients face a permanent loss of saliva, destroyed taste buds, digestive issues, and an inability to talk, eat, swallow, or breathe. And when it comes to the cost of covering incidentals like specialty foods, commuting, and the many small but crucial steps toward recovery, health insurance is often insufficient.

Kerxton had an idea. She inquired at the treatment center about the leftover radiation masks, the ghostly white shells of former patients. With permission from the center’s radiation therapists, she took home the discarded masks and called upon her artist friends to help transform them into works of art. She then auctioned off the finished objects, using the proceeds to support HNC patients by sending applicants a $500 check through a Maryland-based nonprofit called 9114HNC (Help for Head and Neck Cancer).

Since the first Courage Unmasked event in 2009, held at American University’s Katzen Arts Center in Washington, D.C.—which featured 108 masks, decorated by more than 100 artists—other such events have followed, each raising more money for 9114HNC.

Photo by Ulf Wallin Photography.

Carol Kanga, an artist and HNC survivor, co-chaired the inaugural Courage Unmasked event and created a mask for the auction. “My attitude toward my mask was gratitude for the safety it represented,” she told me. “It meant precise treatment, the best available. When I walked into the radiation room and looked up at the shelves, scores of masks looked back at me. They signaled that I was not alone, that hundreds of people get through this, that each of us is a distinct individual receiving excellent treatment tailored exactly to each contour of our bodies.”

Her mask, she has said, “is designed to entice viewers to rejoice with me that life is and that we all are part of it.” And the range of other artist-adorned masks testifies to that life-affirming attitude. Some of the works are celebratory, like totemic symbols of victory over incalculable odds, while others are somber and severe, like fragile reminders of death. Flowers in bloom are a recurring theme, as are birds and their delicate, multicolored feathers.

Barbara Kerne created a mask inspired by Athena, the Greek goddess of arts and crafts who is said to have taken the form of an owl. Athena also happens to be the goddess of wisdom and strength, and thus, Kerne says, a symbol of “heroic endeavor and patron of those who need help.”

For artist Jeanne Heifetz, the mask, as an artifact of radiation, carried twin burdens of fear and hope. “I wanted to transform the emotional connotations of the mask, using alternative meanings of ‘radiation’ and ‘radiance,’” she says. Lacework and reflective copper turn the mask into what she calls a “protective armor for the wearer.”

Several artists sought to maintain the thread from mask wearer to mask reimagined. “This radiation mask came to me from a woman’s daughter in Colorado, who had tenderly sent it off in a box with pictures of mountains on it,” writes artist Anita Hinders in a catalogue that accompanied one Courage Unmasked event. “I think of this mask, Shades of Colorado, as a love letter continued.”

Photos by Ulf Wallin Photography

Allen Hirsch, a throat cancer survivor who recently became a board member for Courage Unmasked, hasn’t decided what to do with his mask just yet. “I have it in my living room,” he told me. “Each day I walk past the mask and it reminds me of the treatment experience and the other patients and family members I met at the radiation clinic and the infusion center. The mask is a reminder that life has changed.”

My dad hasn’t decided what to do with his mask, either. When I was home for the holidays, the mask was sitting on the dining room floor, our last name scrawled across the top. In unadorned white, it was bright like a halogen light. Later, I asked if he had any plans for it. He wasn’t sure. I showed him images of the artist-decorated masks in the Courage Unmasked catalogue, which he’d seen in the waiting room at Hopkins.

He liked some of the artwork, he told me, though he wasn’t too impressed by all the birds. He liked the stories, the book’s personal narratives from survivors and from artists trying to comprehend what he and others had been through, the most.

Dad was only a few days into radiation treatment when he first thumbed through the book at Hopkins, before he lost weight, his sense of taste, his hair, his voice. As those things come back to him, however slowly, he has come to appreciate those stories more. His trophy, as he calls his mask, is a symbol of his own story and how he was lucky, too.

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January, 2018|Oral Cancer News|

Bacteria linked to periodontitis may play role in onset of cancer

Source: en.brinkwire.com
Author: press release

The bacteria that cause periodontitis, a disease affecting the tissues surrounding the teeth, seems to play a part also in the onset of pancreatic cancer, say the researchers at the University of Helsinki and the Helsinki University Hospital, Finland, and the Karolinska Institutet, Sweden.

The researchers have investigated the role of bacteria causing periodontitis, an inflammation of the tissues surrounding the teeth, in the development of oral cancers and certain other cancers, as well as the link between periodontitis and cancer mortality on the population level.

The study, published in the British Journal of Cancer, has for the first time proven the existence of a mechanism on the molecular level through which the bacteria associated with periodontitis, Treponema denticola (Td), may also have an effect on the onset of cancer. Researchers found that the primary virulence factor of the Td bacteria, the Td-CTLP proteinase (an enzyme), occurs also in malignant tumors of the gastrointestinal tract, for example, in pancreatic cancer.

According to another study finding, the CTLP enzyme has the ability to activate the enzymes that cancer cells use to invade healthy tissue (pro-MMP-8 and -9). At the same time, CTLP also diminished the effectiveness of the immune system by, for example, inactivating molecules known as enzyme inhibitors.

In another study, published in the International Journal of Cancer, it was proven that on the population level, periodontitis is clearly linked with cancer mortality. An especially strong link to mortality caused by pancreatic cancer was found. Some 70,000 Finns took part in this 10-year follow-up study.

“These studies have demonstrated for the first time that the virulence factors of the central pathogenic bacteria underlying gum disease are able to spread from the mouth to other parts of the body, most likely in conjunction with the bacteria, and take part in central mechanisms of tissue destruction related to cancer,” says Timo Sorsa, a professor at the University of Helsinki.

Researchers have come to the conclusion that a low-grade systemic inflammation related to periodontitis facilitates the spreading of oral bacteria and their virulence factors to other parts of the body. They point out that the prevention and early diagnosis of periodontitis are very important not only for patients’ oral health, but their overall wellbeing.

“In the long run, this is extremely cost-effective for society,” notes Sorsa.

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January, 2018|Oral Cancer News|

HPV leads to increase In head and neck cancer In men

Source: www.nbcdfw.com
Author: Bianca Castro

The number of men diagnosed with head and neck cancer caused by human papillomavirus has skyrocketed. This report found that 11 million men and 3.2 million women in the United States are infected with some type of oral HPV and oncologists say it’s leading to more head and neck cancer in men.

“From the 1970’s to today, the prevalence of this HPV-related head and neck cancer has increased by three to five percent per year from then until now, and it is continuing that same rate,” said Oncologist Jerry Barker, Jr., M.D. at Texas Oncology.

“This is a silent epidemic. Most patients who are exposed to this virus, they don’t know it. They’ll never have symptoms from it, but some of those patients will move on to develop a cancer,” said Dr. Barker.

Jeff Busby, of Weatherford, is one of those patients. The aerospace engineer and owner of Busby Quarter Horses says he was diagnosed with throat cancer in February of 2016. His wife Andrea, who documented their journey here, says they were both shocked.

“We were just busy living life. You don’t ever think that shoe is going to drop,” said Andrea.

Jeff says the symptoms began as pain in his ear which lead to pain in his throat. Nine months later, he had a biopsy done on what was a mass in his neck.

“I had just been toughing it out and my partner said, ‘hey, you can’t just tough these kinds of things out. You’ve got to go get this checked out,'” said Jeff.

“It was the cancer putting pressure on and radiating nerve pain to the ear. There was nothing wrong with the ear whatsoever,” said Jeff.

A biopsy revealed Jeff had throat cancer caused by the human papillomavirus, the most common sexually transmitted infection.

Jeff was likely exposed in his teens or 20s, but now decades later, created a cancer with one of the most gruesome treatment protocols. He needed surgery to remove his bottom teeth and part of his jaw, 35 radiation treatments and six rounds of chemotherapy.

“I couldn’t let any of my energy go towards feeling sorry for myself because I had to have every amount of energy I had to beat this thing,” said Jeff.

Jeff had never heard of HPV before, while Andrea says she thought it was linked to only cervical cancer.

While pap smears screen for cervical cancer, there is no screening for hpv-related head and neck cancer and that may be part of the reason rates of hpv-related head and neck cancer has surpassed the rate of hpv-related cervical cancer.

There is way to stop the epidemic. The HPV vaccine is recommended for children as early as 11-years-old and young adults as old as 26 years of age. However, according to this study, in Texas, only 35 percent of children get the vaccine.

“Somewhere along the way, these vaccines developed the idea that they had to do with human sexuality and preventing a sexually transmitted disease, but in reality, they are designed to prevent cancer. These are cancer vaccines,” said Dr. Barker.

“If you could just see what some of our patients have to go through to cure one of these cancers, you would run to get the needle in the arm to prevent that from happening to one of your children.”

At 55, Jeff never had the chance to benefit from the vaccine, approved for use in 2006. He’s now cancer free and in some ways, he says, life is better than before cancer.

“I thank God for this challenge and I still wouldn’t change it today. I wouldn’t take it all away because I didn’t think I could be closer to the Lord or to my wife and I certainly have a much better relationship with both,” said Jeff.

He and Andrea are focused on raising vaccination rates and preventing the kind of cancer battle they fought from from happening to someone else.

“There are so many parents that even hear about but still choose not to do it. It’s beyond me. I can’t understand that,” said Jeff.

“Whether it gets a kid vaccinated or somebody sitting on their couch goes, ‘I have ear pain when I swallow. I should go to the doctor.’ That’s why we are doing this,” said Andrea.

The Centers for Disease Control estimates that most Americans have some type of HPV strain but not all strains lead to cancer. Some of the symptoms are head and neck cancer include ear pain, difficulty swallowing and a painless lump on the side of the neck.

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January, 2018|Oral Cancer News|

Dentists may soon start asking about your sex life in a bid to control staggering HPV rates

Source: www.dailymail.co.uk
Author: Jaleesa Baulkman for DailyMail.com

Your dentist may be interested in more than just your flossing habits, but for a good reason. Dentists and dental hygienists are being encouraged to assess patients’ risk of developing oral cancers from HPV, the most common sexually-transmitted disease.

According to experts, they will likely skirt around the topic of their patients’ sex life and ask about potential symptoms of cancer like jaw pain and swelling.

But a new report published in the Journal of the American Dental Association insists it is imperative that dentists to play a more active role in detecting the disease, which is linked to seven types of cancer.

‘What we’re going to find over time is that HPV is going to be a more common cause of cancer over time,’ Ellen Daley, a public health professor at the University of South Florida, told Daily Mail Online. ‘We need to worry about how to prevent it.’

HPV is responsible for about 70 percent of oropharyngeal cancers in the US, according to the Centers for Disease Control and Prevention. The most common sexually transmitted infection in the US, it affects more than half of American adults. In fact, Dr Daley says it’s as common as the common cold.

However, asking about a patient’s sex life isn’t necessary to preventing HPV-related oral cancers.

‘If [dentists] want to [ask patient’s about their sex life], they can, Dr Daley explained. ‘But that’s not relevant since HPV is so common. We need to get pass how it’s transmitted and worry about preventing cancers.’

There have been nearly 16,000 annual cases of oropharyngeal cancers — cancer of the tongue, tonsils and pharyngeal wall — between 2008 and 2012, with HPV being the cause of approximately 72 percent of those diagnoses, according to data.

For the study, Dr Daley and her team conducted four focus groups with a total of 33 dentists.

Research showed that most dentists knew HPV was a risk factor for oropharyngeal cancer, but several were not sure about what causes HPV-related oral cancer.

The study found that many dentists don’t know how to approach the subject of HPV and lack the communication skills needed to educate patients effectively.

Most dentists said they were concerned their patients would think they were judging their personal behaviors. In other words, asking patient’s about their sex lives is out of the question. However, dentists and dental hygienists are trained to screen for oral cancers.

Examining the area under the tongue and looking in the back of a patients’ mouth are ways dentists screen for oral cancer. However, HPV-related oral cancers are difficult to detect because they develop in the throat at the back of the tongue, or in the folds of the tonsils, according to the American Dental Association.

HPV oral and oropharyngeal cancers are harder to discover than tobacco related cancers because the symptoms are not always obvious to the individual who is developing the disease, or to professionals that are looking for it. They can be very subtle and painless

HPV, which is transmitted through vaginal, anal and oral sex, is the most commonly sexually transmitted infection in the US, according to the CDC, affecting more than 79 million Americans. There are more than 40 types of HPV that can affect the mouth and genitals, but HPV 16 and 18 are the two most common cancer-causing types. According to the CDC, HPV type 16 is responsible for 60 percent of all oropharyngeal cancers. Non-cancer types of HPV can cause warts in the mouth or throat.

Some symptoms to look out for include, a persistent sore throat, earaches, enlarged lymph nodes, unexplained weight loss and painful swallowing. However, some people have no signs or symptoms, according to the CDC.

The HPV vaccine, which is administered to children aged nine and 12 years old in the US and the UK, is a preventive measure against HPV and HPV-related cancers. The vaccine is offered as a three doses in the US, and two doses in the UK. Condoms and dental dams also serve as protective barriers against the disease.

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January, 2018|Oral Cancer News|